Circulatory assist devices have been used for both temporary and long-term support for the failing myocardium. A registry was set up under the auspices of The Australasian Society of Cardiac and Thoracic Surgeons to monitor the use of these devices and to allow analysis of the results. A standardised data form was sent to each of the 26 Australian cardiac surgery centres. Patient data were grouped according to age (paediatric and adult) and intention to treat (postcardiotomy temporary support or long-term bridge-to-transplantation). Ten centres contributed data. Between 1989 and 1994 ventricular assist devices (VAD) were used in 92 patients: 65 had postcardiotomy support, 24 were bridged to transplantation, and 3 had posttransplant support. In the postcardiotomy group 90% of patients were supported for less than 1 week, and the hospital discharge rate was 37%. In the bridge-to-transplant group the mean support period was 50 days, and the discharge rate post-transplantation was 42%. These results compare favourably with those of a large international registry: 25% discharge in postcardiotomy patients and 49% in bridge-to-transplant patients. With good patient selection VADs can provide excellent myocardial support in a patient population with a high probability of multiorgan failure and death. Technological developments in support devices and the changing operative population mandate the ongoing maintenance and periodic review of device usage in Australia.